Doulas: The Differences and Benefits
As any parent will tell you, a typical newborn/infant is awake and in need of care for several hours every night for at least 3-5 months. In the past, most parents had extended family members to help with this 24-hour schedule, and mothers were able to remain in the birthing center or hospital to recuperate. Today, however, family members are geographically spread out or cannot leave work themselves, and most mothers are not given the chance to properly heal before being sent back home (and back to work!). In order to get the vital sleep needed to care for their family and function at work outside the home, some new parents choose to employ postpartum help such as baby nurses, newborn caregivers or postpartum doulas.
Traditionally, overnight nanny responsibilities have been held by women with the title of baby nurse. Usually this was family member or well-respected woman in the community. By today’s modern standards, however, a baby nurse is a Registered Nurse (RN) or Licensed Practical Nurse (LPN) with specific training in the clinical and practical care of newborns and infants. Further, in many states the term “baby nurse” can only be used legally if the person practicing this profession is an actual RN or LPN.
For individuals who have experience in newborn care but do not hold specific medical licenses, the term newborn care specialist is now used. However, state and national licenses for the care of 1-3 children do not exist, so there is no certification or monitoring of individuals who use this title. The extent of the caregiver’s experience can vary widely.
A baby nurse performs all tasks related to baby’s well-being. While they are required to keep the child’s room orderly and clean, they do not perform household duties. The role of the baby nurse includes: bottle feeding, diapering, changing linens, changing clothing and soothing the child through the night. An important component of this care is holding baby upright for 20-30 minutes after feeding, as recommended by the American Academy of Pediatrics. For parents who choose to use formula at night, 8-10 hours of uninterrupted sleep is typical. For mothers who exclusively breastfeed, a baby nurse can use expressed breast milk in a bottle, or bring the child to mother. The nurse then provides all other care for baby by burping, soothing, changing and easing baby back to sleep. For breastfeeding moms this means an average of 2-3 extra hours per night of sleep.
With both clinical and practical experience, the baby nurse helps the whole family. Knowing baby is in capable, nurturing hands just as s/he was in the hospital nursery, mothers get the deep restorative sleep their bodies need to recuperate from the emotional and physical demands of childbirth. For mothers who work outside the home and stay-at-home moms alike, baby nurses allow for proper rest so she can be present and effective during the day. New dads and partners benefit in these same ways.
Siblings also benefit from baby nurses. Parents can be available to comfort older children when they inevitably wake up during the night as they adjust to new baby sounds and activity. Toddlers in particular, who cannot yet articulate their feelings and may be confused, need extra parental comfort as they adjust to life with the new little one. For families with twins or more, overnight help allows parents to bond with each child individually or simply have relief from the demanding feeding schedule of multiple babies.
For the babies themselves of course, the baby nurse allows their needs to be met quickly and lovingly by a professional pediatric caregiver. The nurse does not replace family, rather she is another nurturing presence caring for and monitoring the child. For this reason, she often becomes regarded as “one of the family.”
The role of the postpartum doula is to be available to all members of the family as they transform into a new family unit. While it is true that the doula “mothers the mother,” assisting mom with anything she needs to be able to care for the child, she also tends to siblings, and provides support to fathers and partners. According to Doulas of North America (DONA), “The doula provides non-medical support and companionship, assists with newborn care and sibling adjustment, meal preparation and household organization.” A doula will not exclusively care for baby overnight, rather she will provide whatever the family needs to take care of themselves as well as their newest member. Her role is to support the family unit as much as needed.
While doulas do not perform medical tasks or clinical care, a large part of their role is to provide evidence-based education for families. They assist with instruction about baby care, breastfeeding and teaching other family members how to take care of mother. Additionally, the doula provides fathers and partners with support. This can mean providing gentle support with early bonding and questions, or simply listening to the new parent’s concerns.
Required to have contact information for at least 45 outside care resources such as La Leche League, postpartum support groups or other parent organizations, the doula is also a vital source of information if needed. It is important to note that the doula does not judge or take a position on any parenting decisions. Rather she helps to provide a calm, encouraging environment for families to find their own path as they journey into their new family dynamic.
The times a doula works with a family vary greatly. She may live-in, work during the day or provide care overnight. Since a large part of the doula’s scope of care is to help the family discover self-confidence in their child and family care abilities, there is no exact timeframe to use a doula. The goal is that as families grow more confident, the need for a doula’s care naturally diminishes. Because of the positive, nurturing impact of a doula, she is oftentimes regarded as a member of the family.
The type of care parents select as they evolve into a new family unit is a deeply personal choice. Whether it is family or church members, a baby nurse or postpartum doula, good outside help can contribute to the overall well being of the family. Each of these caregivers gives new parents the gift of health, rest and peace of mind.
Editorial provided by Denise Stern. Denise Stern is the owner of Let Mommy Sleep, LLC, the first and only baby nurse agency serving the Washington DC and Baltimore Metro areas. She is also a mother to 21-month-old identical twin girls and a beautiful 3-year-old boy.